Policy Challenges and Opportunities to Address Changing Paradigms in Cancer Care Delivery

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  • a National Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania;
  • b UAB Health System, Birmingham, Alabama;
  • c Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois;
  • d Stanford University School of Medicine, Stanford, California;
  • e Lee N. Newcomer Consulting, Minnetonka, Minnesota; and
  • f Fox Chase Cancer Center, Philadelphia, Pennsylvania.
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Multiple factors are forcing the healthcare delivery system to change. A movement toward value-based payment models is shifting these systems to team-based integration and coordination of care for better efficiencies and outcomes. Workforce shortages are stressing access and quality of care for patients with cancer and survivors, and their families and caregivers. Innovative therapies are expensive, forcing payers and employers to prioritize resources. Patients are advocating for care models centered on their needs rather than those of providers. In response, payment policies have recently focused on the promotion of alternative payment models that incentivize coordinated, high-quality care with consideration for value and controlling the increasing overall costs associated with cancer and its treatment. Given the multitude of factors confounding cancer care, NCCN convened a multistakeholder working group to examine the challenges and opportunities presented by changing paradigms in cancer care delivery. The group identified key challenges and developed policy recommendations to address 4 high-visibility topics in cancer care delivery. The findings and recommendations were then presented at the NCCN Policy Summit: Policy Challenges and Opportunities to Address Changing Paradigms in Cancer Care Delivery in September 2018, and multistakeholder roundtable panel discussions explored these findings and recommendations along with additional items. This article encapsulates the discussion from the NCCN Working Group meetings and the NCCN Policy Summit, including multistakeholder policy recommendations on delivery issues in cancer care designed to help inform national policies moving forward.

Submitted February 19, 2019; accepted for publication March 15, 2019.

Disclosures: Dr. Newcomer has disclosed that he serves on the board for Cellworks, and is a scientific advisor for Grail, Loxo Pharmaceuticals, Merrimack Pharmaceuticals, Mobil ODT, Reflexion Medical, RxFunction, Trakcel, Xenex. The remaining authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. Ms. Winckworth-Prejsnar, Mr. McCanney, Ms. Schatz, Ms. Fitzgerald, and Dr. Carlson are employed by the National Comprehensive Cancer Network.

Correspondence: Katy Winckworth-Prejsnar, MPH, National Comprehensive Cancer Network, 3025 Chemical Road, Suite 100, Plymouth Meeting, PA 19462. Email: winckworthprejsnar@nccn.org

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